MEDICARE: NANCY COLETTE MONTZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	200401279	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518962711
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY COLETTE MONTZ MD

Provider Business Mailing Address
First Line	:	PO BOX 601488
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28260-1488
Country	:	US
Telephone Number	:	704-548-8724
Fax Number	:	704-548-0927

Provider Business Practice Location Address
First Line	:	101 E WT HARRIS BLVD
Second Line	:	SUITE 5002
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-3485
Country	:	US
Telephone Number	:	704-548-8724
Fax Number	:	704-548-0927

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	01/05/2010

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